Rethinking Autism, 1st Edition

Variation and Complexity

A provocative book that comprehensively reviews research on autism and suggests the evidence points toward "autism" being several disorders rather than one, and the implications thereof for finding a cure

Key Features

Autism is a massive worldwide problem with increasing prevalence rates, now thought to be as high as 1 in 38 children (Korea) and 1 in 100 children (CDC- US)

Autism is the 3rd most common developmental disability; 400,000 people in the United States alone have autism

Autism affects the entire brain, including communication, social behavior, and reasoning and is lifelong

There is no known cause and no cure

Funding for autism research quadrupled from 1995 to 2000 up to $45 million, and the Interagency Autism Coordinating Committee has recommended $1 billion funding from 2010-2015

Description

The media, scientific researchers, and the Diagnostic and Statistical Manual all refer to "autism" as if it were a single disorder or a single disorder over a spectrum. However, autism is unlike any single disorder in a variety of ways. No single brain deficit is found to cause it, no single drug is found to affect it, and no single cause or cure has been found despite tremendous research efforts to find same. Rethinking Autism reviews the scientific research on causes, symptomology, course, and treatment done to date…and draws the potentially shocking conclusion that "autism" does not exist as a single disorder. The conglomeration of symptoms exists, but like fever, those symptoms aren’t a disease in themselves, but rather a result of some other cause(s). Only by ceasing to think of autism as a single disorder can we ever advance research to more accurately parse why these symptoms occur and what the different and varied causes may be.

Lynn Waterhouse

Dr. Lynn Waterhouse was the Director of Child Behavior Study at The College of New Jersey for 31 years, and is currently a Professor in Global Graduate Programs at the College. NIMH, NICHD, and private funding agencies supported her autism research. She worked with Dr. Lorna Wing on the APA DSM-III-R diagnostic criteria for autism.

Intelligence, Savant and Superior Skills, and Sensory Abnormalities in Autism

Conclusions: Theories of Savant Skills Do Not Explain Variation, and Public Attention to Savant Skills Supports an Unhelpful Stereotype of Autism

References

Chapter 7. Increasing Prevalence and the Problem of Diagnosis

Pressing Problems for the Diagnosis of Autism

Conflicts in Stakeholder Ownership of the Diagnosis of Autism

The Difficulties Inherent in the DSM System of Classification

Problems with DSM-5 Autism Spectrum Diagnostic Criteria

Conclusion: An Originalist View of Autism Avoids the Complexity of Evidence

References

Chapter 8. Autism Symptoms Exist but the Disorder Remains Elusive

The Autism Male to Female Ratio is Likely to be a Composite

Much Research is Still Focused on Trying to Unify Autism as a Single Disorder

Abandoning Autism as a Single Disorder Would Eliminate Three Inferential Problems in Autism Research

The Existing Quandary and the Argument for Autism as Symptoms

Conclusion: Autism Symptoms without a Disorder

References

Subject Index

Quotes and reviews

"A seminal book forcing a much-needed change in the way in which we think about autism. Impressively well-researched and well-argued. A 'must-read' for all autism researchers."

--Prof. Jill Boucher, City University, London, UK

"This book by Lynn Waterhouse will ruffle some feathers, with its bold conclusion that "there is clear detriment to maintaining the diagnostic category of autism spectrum disorder." However, the evidence she presents is compelling. In every domain she investigates - symptoms, neurobiology, etiology, correlates – she finds that there is considerable heterogeneity in autism. As well as striking differences among children with an ASD diagnosis, there is also a lack of specificity in symptoms and causes. For instance, genetic variants and environmental risks that are associated with increased risk of autism are also associated with other neurodevelopmental disorders.

Waterhouse is not denying that there are children with severe developmental difficulties involving social interaction, communication and stereotyped behaviours. Rather, she is questioning whether their needs are best served by grouping them all together under a single umbrella label.

Her view is that research efforts directed at finding a unifying theory of autism are misguided, and that we should be focusing on symptoms rather than an abstract diagnostic category that can obfuscate rather than clarify our understanding."

--Prof. Dorothy Bishop, University of Oxford, UK

"The book is an argument, not an opinion piece or political manifesto. It presents a pile of research findings, and makes a case for what they tell us…I’m grateful for Lynn Waterhouse’s book and fervently hope it will help knock autism research out of a rut (not to mention help improve everyday thinking about autism)… Rethinking Autism moves the conversation forward and I hope it will change our thinking for the better."--Intellectualizing blog, December 17, 2013